2010-2019年开封市新报告15岁及以上HIV/AIDS患者首次CD4细胞检测情况

First detection of CD4 cells in newly reported HIV/AIDS patients aged 15 and above in Kaifeng City from 2010 to 2019

目的了解2010-2019年开封市新报告15岁及以上HIV/AIDS患者首次CD4细胞检测情况,分析影响因素。方法资料来源于中国疾病预防控制信息系统,收集患者相关信息,采用χ^(2)检验、Logistic回归对首次CD4细胞检测情况进行分析。结果新报告的1579人中,确诊后14天内接受CD4细胞检测501人(31.7%)。365天内检测CD4细胞的1510人中,小于200个/μL的370人(24.5%)。多因素回归分析显示,职业为家政、家务及待业和其他的患者首检及时的概率是农民的1.451倍(OR=1.451,95%CI:1.044~2.015)和1.383倍(OR=1.383,95%CI:1.053~1.816);其他途径感染者首检及时的概率是异性途径感染者的63.6%(OR=0.636,95%CI:0.426~0.928)。与≤45岁患者相比,46~69岁组(OR=1.721,95%CI:1.306~2.268)和≥70岁组(OR=1.663,95%CI:1.025~2.698)的首次CD4细胞<200个/μL风险较高;经同性性行为途径感染者首次CD4细胞<200个/μL的风险低于异性途径感染者(OR=0.435,95%CI:0.296~0.641),而其他途径感染者高于异性性行为感染患者(OR=1.596,95%CI:1.123~2.268);来源于医疗机构患者首次CD4细胞<200个/μL的风险高于来源于检测咨询患者(OR=1.807,95%CI:1.361~2.398)。结论开封市新报告HIV/AIDS患者CD4细胞首检及时性仍待提高,且存在一定比例的晚发现病例。仍需针对不同职业、接触史、年龄、病例来源采取相应的宣传干预方法,达到早检测、早发现、早治疗。

Objective To investigate the CD4 cells testing situation and the influencing factors in newly reported HIV/AIDS patients aged 15 and above in Kaifeng City from 2010 to 2019.Methods We collected data from the Chinese Disease Prevention and Control Information System.The baseline CD4 cell testing situation at HIV diagnosis and its associated factors were analyzed using chi-square test and logistic regression.Results Of the 1,579 newly reported HIV cases,501(31.7%)received CD4 cell tests within 14 days after the HIV diagnosis.Among 1,510 people who had the CD4 cell value detected within 365 days,370(24.5%)had a CD4 cell value less than 200 cells/μL.Multivariate regression analysis showed,compared to farmers,patients with the occupation of housekeeping or housework(OR=1.451,95%CI:1.044~2.015)and being unemployed or others(OR=1.383,95%CI:1.053~1.816)were more likely to have their baseline CD4 cell timely tested.Patients infected with HIV through heterosexual transmission were 1.572 times likely to have their baseline CD4 cell timely tested than those infected through other transmission routes(OR=0.636,95%CI:0.426~0.928).The analysis of the baseline CD4 test results showed that the likelihood of having baseline CD4 cell value less than 200 cells/μL among patients aged 46-69 years old(OR=1.721,95%CI:1.306~2.268)and 70 years old and above(OR=1.663,95%CI:1.025~2.698)was higher than those aged under 45 years old.Compared to patients infected through heterosexual sex,those infected through homosexual sex had a lower risk of having a baseline CD4 cell value less than 200 cells/μL(OR=0.435,95%CI:0.296-0.641),but those infected through other transmission routes had a higher risk(OR=1.596,95%CI:1.123-2.268)of having a baseline CD4 cell value less than 200 cells/μL.The risk of a baseline CD4 cell value less than 200 cells/μL among patients detected from medical institutions was higher than those from a voluntary testing consultation(OR=1.807,95%CI:1.361~2.398).Conclusions The timely baseline CD4 cell testing among newly reported HIV cases in Kaifeng still needs to be improved.There was a certain proportion of late detected cases.It is necessary to take corresponding publicity and intervention methods to achieve early detection,early detection,and early treatment based on different occupations,contact history,age,and source of cases.